What is gabapentin?

Gabapentin (Neurontin, Gralise, Horizant) is a medicine used to treat partial seizures, nerve pain from shingles and restless leg syndrome. It works on the chemical messengers in your brain and nerves.  Gabapentin is from a group of medicines called anticonvulsants. 

Different brands of gabapentin are not interchangeable and they are FDA approved for different conditions. Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form. 

Neurontin (gabapentin) is used to treat pain you may have from shingles (postherpetic nerve pain). It is also used with other seizure medicines for partial onset seizures in patients 3 years and older.

Gralise (gabapentin) is only used for pain after having shingles (postherpetic nerve pain). It should not be used for any other medical condition.

Horizant (gabapentin enacarbil) is an extended release tablet used to treat restless legs syndrome and for the pain from having shingles (postherpetic nerve pain).

Generic brands of gabapentin capsules, USP are used for postherpetic nerve pain and for add on therapy for partial onset seizures in patients 3 years and older

Warnings

Gabapentin can cause life-threatening breathing problems, especially if you already have a breathing disorder or if you use other medicines that can make you drowsy or slow your breathing. Seek emergency medical attention if you have very slow breathing.

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.

Seizures may increase if you stop using gabapentin suddenly. Ask your doctor before stopping the medicine.

Avoid driving or hazardous activity until you know how gabapentin will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Do not stop using gabapentin suddenly, even if you feel fine.

Before taking this medicine

You should not take gabapentin if you are allergic to it.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• breathing problems;
• diabetes;
• depression, a mood disorder, or suicidal thoughts or actions;
• drink alcohol;
• a history of drug addiction;
• a seizure;
• (patients with RLS) if you are a day sleeper or work a night shift; or
• kidney disease (or if you are on dialysis).

Some people have thoughts about suicide while taking seizure medicine. Children taking gabapentin may have behavior changes. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

It is not known if gabapentin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Do not start or stop seizure medication during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of gabapentin on the baby.

Ask a doctor if it is safe to breastfeed while using gabapentin.

How should I take gabapentin?

Take gabapentin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Never take gabapentin in larger amounts, or for longer than prescribed.

Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the medicine your doctor prescribes.

Both Gralise and Horizant should be taken with food.

Neurontin can be taken with or without food.

If you break a tablet and take only half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.

Swallow the tablets of Gralise and Horizant whole. Do not crush, break, or dissolve them. Swallow the capsule whole and do not crush, chew, break, or open the capsule.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Doses are based on weight in children. Your child’s dose may change if the child gains or loses weight.

You should not stop taking gabapentin suddenly. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using gabapentin.

Your kidney function may need to be checked often and your dose may change based on the results.

Store tablets and capsules at room temperature away from moisture and heat.

Store the liquid medicine in the refrigerator, do not freeze.

Follow all storage instructions provided. Your pharmacist can provide more information about how to store this medicine.

Dosing information

Usual Adult Dose for Epilepsy:

Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
Maintenance dose: 300 to 600 mg orally 3 times a day
Maximum dose: 3600 mg orally daily (in 3 divided doses)
-Maximum time between doses in the 3 times a day schedule should not exceed 12 hours

-The safety and effectiveness of gabapentin available under the trade name Gralise or Horizant in patients with epilepsy has not been studied.

Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization

Usual Adult Dose for Postherpetic Neuralgia:

-Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
-Titrate up as needed for pain relief
-Maximum dose: 1800 mg per day (600 mg orally 3 times a day)
Gabapentin available under the trade name Gralise:
-Maintenance dose: Gralise should be titrated to 1800 mg orally once daily with the evening meal.
-Recommended titration schedule:
Day 1: 300 mg orally with the evening meal
Day 2: 600 mg orally with the evening meal
Days 3 through 6: 900 mg orally with the evening meal
Days 7 through 10: 1200 mg orally with the evening meal
Days 11 through 14: 1500 mg orally with the evening meal
Day 15: 1800 mg orally with the evening meal
COMMENT:
-Gralise is not interchangeable with other gabapentin products because of differing pharmacokinetic profiles that affect the frequency of administration.

Gabapentin enacarbil extended release tablets are available under the trade name Horizant:
-The recommended dosage is 600 mg orally 2 times a day. Therapy should be initiated at a dose of 600 mg orally in the morning for 3 days of therapy, then increased to 600 mg 2 times a day (1200 mg/day) on day four.
COMMENT:
Gabapentin enacarbil extended release tablets available under the trade name Horizant and gabapentin are not interchangeable.

Use: Postherpetic neuralgia

Usual Adult Dose for Restless Legs Syndrome:

Gabapentin enacarbil available under the trade name Horizant:
600 mg orally once daily with food at about 5 PM

Use: For the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS) in adults

Usual Pediatric Dose for Epilepsy:

Less than 3 years: Not recommended

Greater than or equal to 3 and less than 12 years:
Starting Dose: Ranges from 10 to 15 mg/kg/day in 3 divided doses
Effective Dose: Reached by upward titration over a period of approximately 3 days; the effective dose in patients 5 years of age and older is 25 to 35 mg/kg/day in divided doses (3 times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (3 times a day). Gabapentin may be administered as the oral solution, capsule, or tablet, or using combinations of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long term clinical study. The maximum time interval between doses should not exceed 12 hours.

Greater than 12 years:
-Initial dose: 300 mg orally on day one, 300 mg orally 2 times a day on day two, then 300 mg orally 3 times a day on day three
-Maintenance dose: 900 to 1800 mg orally in 3 divided doses; the dose may be increased up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.

Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization in patients 3 years of age and older<

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

If you take Horizant: skip the missed dose and take your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . An overdose can be fatal.

Overdose symptoms may include slow breathing, double vision, tremor, slurred speech, drowsiness, change in your mental state, dizziness, tiredness, or diarrhea.

What should I avoid while taking gabapentin?

Avoid driving or hazardous activity until you know how gabapentin will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Avoid taking an antacid within 2 hours before you take gabapentin.

Do not drink alcohol. Dangerous side effects could occur.

Gabapentin side effects

Get emergency medical help if you have signs of an allergic reaction to gabapentin: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Gabapentin can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Some side effects are more likely in children taking gabapentin. Call your doctor if the child has any of the following side effects: behavior changes, memory problems, trouble concentrating, or acting restless, hostile, or aggressive.

Gabapentin may cause serious side effects. Call your doctor at once if you have:

• drowsiness, dizziness, weakness;
• problems with balance or muscle movement; or
• increased seizures.

Common gabapentin side effects may include:

• fever, chills, sore throat, body aches, tiredness;
• headache;
• swelling of your legs and feet;
• trouble speaking;
• vision problems, dizziness, drowsiness;
• tremors, problems with balance or muscle movement; or
• nausea, vomiting.

Uses for gabapentin enacarbil

Gabapentin enacarbil is used to treat moderate-to-severe primary Restless Legs Syndrome (RLS). RLS is a neurologic disorder that makes the legs feel uncomfortable. This results in an irresistible feeling of wanting to move your legs to make them comfortable.

Gabapentin enacarbil is also used to manage a condition called postherpetic neuralgia, which is pain that occurs after shingles.

This medicine is available only with your doctor’s prescription.

Before using gabapentin enacarbil

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of gabapentin enacarbil in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of gabapentin enacarbil in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving gabapentin enacarbil.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acepromazine
• Alfentanil
• Alprazolam
• Amobarbital
• Anileridine
• Aripiprazole
• Asenapine
• Baclofen
• Benperidol
• Benzhydrocodone
• Bromazepam
• Buprenorphine
• Buspirone
• Butabarbital
• Butorphanol
• Calcifediol
• Calcium Oxybate
• Cannabidiol
• Cannabis
• Carbinoxamine
• Carisoprodol
• Carphenazine
• Chloral Hydrate
• Chlordiazepoxide
• Chlorpromazine
• Chlorzoxazone
• Clobazam
• Clonazepam
• Clorazepate
• Clozapine
• Codeine
• Cyclobenzaprine
• Daridorexant
• Dexmedetomidine
• Diacetylmorphine
• Diazepam
• Dichloralphenazone
• Difenoxin
• Dihydrocodeine
• Diphenhydramine
• Diphenoxylate
• Doxylamine
• Droperidol
• Enflurane
• Esketamine
• Estazolam
• Eszopiclone
• Ethchlorvynol
• Ethopropazine
• Ethylmorphine
• Fentanyl
• Flibanserin
• Fluphenazine
• Flurazepam
• Fluspirilene
• Fospropofol
• Gabapentin
• Halazepam
• Haloperidol
• Halothane
• Hexobarbital
• Hydrocodone
• Hydromorphone
• Hydroxyzine
• Isoflurane
• Ketamine
• Ketazolam
• Ketobemidone
• Lacosamide
• Levocetirizine
• Levorphanol
• Lorazepam
• Loxapine
• Magnesium Oxybate
• Meclizine
• Melperone
• Meperidine
• Mephobarbital
• Meprobamate
• Meptazinol
• Mesoridazine
• Metaxalone
• Methadone
• Methdilazine
• Methocarbamol
• Methohexital
• Methotrimeprazine
• Methylene Blue
• Midazolam
• Molindone
• Moricizine
• Morphine
• Morphine Sulfate Liposome
• Nalbuphine
• Nicomorphine
• Nitrazepam
• Nitrous Oxide
• Olanzapine
• Opium
• Opium Alkaloids
• Orlistat
• Orphenadrine
• Oxazepam
• Oxycodone
• Oxymorphone
• Papaveretum
• Paregoric
• Pentazocine
• Pentobarbital
• Perampanel
• Perazine
• Periciazine
• Perphenazine
• Phenobarbital
• Pimozide
• Piperacetazine
• Pipotiazine
• Piritramide
• Potassium Oxybate
• Prazepam
• Pregabalin
• Primidone
• Prochlorperazine
• Promazine
• Promethazine
• Propofol
• Quazepam
• Quetiapine
• Ramelteon
• Remifentanil
• Remimazolam
• Remoxipride
• Ropeginterferon Alfa-2b-njft
• Secobarbital
• Sertindole
• Sodium Oxybate
• Sufentanil
• Sulpiride
• Suvorexant
• Tapentadol
• Temazepam
• Thiethylperazine
• Thiopental
• Thiopropazate
• Thioridazine
• Tilidine
• Tizanidine
• Tolonium Chloride
• Topiramate
• Tramadol
• Triazolam
• Trifluoperazine
• Trifluperidol
• Triflupromazine
• Trimeprazine
• Zaleplon
• Zolpidem
• Zopiclone
• Zotepine
• Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Dihydroxyaluminum Aminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Ginkgo
• Magaldrate
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Trisilicate

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Depression, history of or
• Lung or breathing problems (eg, respiratory depression) or
• Mental illness, history of—Use with caution. May make these conditions worse.
• Kidney disease (eg, patients receiving dialysis)—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
• Patients who need to sleep during daytime and remain awake at night—Use is not recommended.

Proper use of gabapentin enacarbil

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the extended-release tablet whole. Do not crush, break, or chew it. It should be taken with food.

For patients with restless legs syndrome: Do not use this medicine if you are required to sleep during the daytime and remain awake at night.

Only use the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (extended-release tablets):
  • For restless legs syndrome:
    • Adults—600 milligrams (mg) as a single dose at about 5 PM. Your doctor may adjust your dose as needed and tolerated.
    • Children—Use and dose must be determined by your doctor.
  • For postherpetic neuralgia:
    • Adults—At first, 600 milligrams (mg) once a day taken in the morning for 3 days. Then, your doctor will increase your dose to 600 mg two times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 1,200 mg per day.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using gabapentin enacarbil

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Gabapentin enacarbil may cause dizziness, drowsiness, or sleepiness. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert. If these side effects are especially bothersome, check with your doctor.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors, such as feeling sad or hopeless, getting upset easily, or feeling nervous, restless, or hostile. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these side effects, tell your doctor right away.

This medicine may cause respiratory depression, a serious breathing problem that can be life-threatening, when used together with narcotic pain medicines. Check with your doctor right away if you have pale or blue lips, fingernails, or skin, difficult or troubled breathing, or irregular, fast or slow, or shallow breathing.

Check with your doctor right away if you have a fever, rash, swollen, painful, or tender lymph glands in the neck, armpit, or groin, unusual bleeding or bruising, or yellow eyes or skin. These may be symptoms of a serious and life-threatening allergic reaction called drug reaction with eosinophilia and systemic symptoms (DRESS) or multiorgan hypersensitivity.

Do not stop using this medicine without checking with your doctor. Stopping the medicine suddenly may cause seizures. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely.

Do not drink alcohol while you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of gabapentin enacarbil

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Bloating or swelling of the face, arms, hands, lower legs, or feet
• discouragement
• feeling sad or empty
• irritability
• lack of appetite
• loss of interest or pleasure
• rapid weight gain
• tingling of the hands or feet
• tiredness
• trouble concentrating

Incidence not known

• Black, tarry stools
• bloody or cloudy urine
• changes in behavior
• chest pain or discomfort
• chills or fever
• confusion
• difficulty with breathing
• dizziness or lightheadedness
• fainting
• fast heartbeat
• nausea or vomiting
• painful or difficult urination
• rapid, shallow breathing
• rash
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• swelling of the face, feet, or lower legs
• swollen, painful, or tender lymph glands in the neck, armpit, or groin
• thoughts of killing oneself
• unusual bleeding or bruising
• upper right abdominal or stomach pain
• yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Lack or loss of strength
• sleepiness or unusual drowsiness

Less common

• Blurred vision
• decreased interest in sexual intercourse
• dry mouth
• excess air or gas in the stomach or intestines
• inability to have or keep an erection
• sensation of spinning
• weight gain

What is  Horizant?

Horizant is a  prescription medicine used to treat adults with restless legs syndrome and pain from damaged nerves. It affects chemicals and nerves in the body that are involved in the cause of some types of pain.

Horizant is used in adults to treat nerve pain (postherpetic neuralgia) caused by herpes virus or shingles (herpes zoster).

Horizant is also used to treat restless legs syndrome (RLS).

Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form.

Warnings

Some people have thoughts about suicide while taking this medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Do not stop using Horizant suddenly, even if you feel fine.

Before taking this medicine

You should not use Horizant if you are allergic to gabapentin.

To make sure Horizant is safe for you, tell your doctor if you have ever had:

• lung disease, such as chronic obstructive pulmonary disease (COPD);
• kidney disease (or if you are on dialysis);
• diabetes;
• depression, a mood disorder, or suicidal thoughts or actions;
• a seizure (unless you take gabapentin to treat seizures);
• liver disease;
• heart disease; or
• (for patients with RLS) if you are a day sleeper or work a night shift.

Some people have thoughts about suicide while taking this medicine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Gabapentin enacarbil can pass into breast milk, but effects on the nursing baby are not known. Ask your doctor about any risk.

How should I take Horizant?

Take Horizant exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not cut, crush, chew, or break an extended-release Horizant tablet. Swallow the tablet whole.

If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy.

Do not stop using Horizant suddenly, even if you feel fine. Follow your doctor’s instructions about tapering your dose.

This medicine can cause unusual results with certain  medical tests. Tell any doctor who treats you that you are using gabapentin enacarbil.

Store Horizant extended-release tablets at room temperature away from light and moisture.

Dosing information

Usual Adult Dose of Horizant for Postherpetic Neuralgia:

The recommended dosage is 600 mg orally 2 times a day. Therapy should be initiated at a dose of 600 mg orally in the morning for 3 days of therapy, then increased to 600 mg 2 times a day (1200 mg/day) on day four.
Gabapentin enacarbil extended release tablets available under the trade name Horizant and gabapentin are not interchangeable.
Use: Postherpetic neuralgia

Usual Adult Dose of Horizant for Restless Legs Syndrome:

600 mg orally once daily with food at about 5 PM. A dose of 1,200 mg once daily provided no additional benefit compared with the 600-mg dose, but caused an increase in adverse reactions.
Use: For the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS) in adults

What happens if I miss a dose?

Take the missed dose as soon as you remember. Be sure to take the medicine with food. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What to avoid

Avoid driving or hazardous activity until you know how gabapentin enacarbil will affect you. Your reactions could be impaired.

Drinking alcohol with this medicine can cause side effects.

 Horizant side effects

Get emergency medical help if you have signs of an allergic reaction to Horizant: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, upper stomach pain, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using Horizant.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• weak or shallow breathing;
• blue-colored skin, lips, fingers, and toes;
• confusion, extreme drowsiness or weakness;
• problems with balance or muscle movement;
• unusual or involuntary eye movements; or
• increased seizures.

Gabapentin can cause life-threatening breathing problems. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Breathing problems may be more likely in older adults or in people with COPD.

Some side effects are more likely in children taking gabapentin. Contact your doctor if the child taking this medicine has any of the following side effects:

• changes in behavior;
• memory problems;
• trouble concentrating; or
• acting restless, hostile, or aggressive.

Common Horizant side effects may include:

• headache;
• dizziness, drowsiness, tiredness;
• problems with balance or eye movements; or
• (in children) fever, nausea, vomiting.

What is Lyrica?

Lyrica was originally FDA approved as an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. Pregabalin also affects chemicals in the brain that send pain signals across the nervous system.

Lyrica is used to treat pain caused by fibromyalgia, or nerve pain in people with diabetes (diabetic neuropathy), herpes zoster (post-herpetic neuralgia), or spinal cord injury.

Lyrica may also be used for purposes not listed in this medication guide.

Warnings

Lyrica can cause a severe allergic reaction. Stop taking this medicine and seek emergency medical help if you have hives or blisters on your skin, trouble breathing, or swelling in your face, mouth, or throat.

Some people have thoughts about suicide while taking Lyrica. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

If you have diabetes or heart problems, call your doctor if you have weight gain or swelling in your hands or feet while taking Lyrica.

Do not stop using this medicine suddenly, even if you feel fine. Stopping suddenly may cause withdrawal symptoms.

Do not change your dose without your doctor’s advice. Tell your doctor if the medication does not seem to work as well in treating your condition.

Before taking this medicine

You should not use Lyrica if you are allergic to pregabalin.

To make sure Lyrica is safe for you, tell your doctor if you have ever had:

• lung disease, such as chronic obstructive pulmonary disease (COPD);
• a mood disorder, depression, or suicidal thoughts;
• heart problems (especially congestive heart failure);
• a bleeding disorder, or low levels of platelets in your blood;
• kidney disease (or if you are on dialysis);
• diabetes (unless you are taking pregabalin to treat diabetic neuropathy);
• drug or alcohol addiction; or
• a severe allergic reaction (angioedema).

Do not give this medicine to a child without medical advice.

• Pregabalin is not approved for use by anyone younger than 18 years old to treat nerve pain caused by fibromyalgia, diabetes, herpes zoster, or spinal cord injury.
• Pregabalin is not approved for seizures in anyone younger than 1 month old.

Some people have thoughts about suicide while taking Lyrica. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Follow your doctor’s instructions about taking seizure medication if you are pregnant. Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking this medicine without your doctor’s advice, and tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of pregabalin on the baby.

Pregabalin can temporarily decrease sperm count and may affect fertility in men (your ability to have children). In animal studies, pregabalin also caused birth defects in the offspring of males treated with this medicine. However, it is not known whether these effects would occur in humans. Ask your doctor about your risk.

You should not breastfeed while using pregabalin.

How should I take Lyrica?

Take Lyrica exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take the medicine at the same time each day, with or without food.

Do not crush, chew, or break an extended-release tablet. Swallow the tablet whole.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Call your doctor if your symptoms do not improve, or if they get worse.

Do not stop using Lyrica suddenly, even if you feel fine. Stopping suddenly may cause increased seizures or unpleasant withdrawal symptoms. Follow your doctor’s instructions about tapering your dose for at least 1 week before stopping completely.

In case of emergency, wear or carry medical identification to let others know you take seizure medication.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What to avoid

Avoid drinking alcohol. It may increase certain side effects of Lyrica.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Lyrica side effects

Lyrica can cause a severe allergic reaction. Stop taking this medicine and get emergency medical help if you have: hives or blisters on your skin; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• weak or shallow breathing;
• blue-colored skin, lips, fingers, and toes;
• confusion, extreme drowsiness or weakness;
• vision problems;
• skin sores (if you have diabetes);
• easy bruising, unusual bleeding;
• swelling in your hands or feet, rapid weight gain (especially if you have diabetes or heart problems); or
• unexplained muscle pain, tenderness, or weakness (especially if you also have fever or don’t feel well).

Pregabalin can cause life-threatening breathing problems. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Breathing problems may be more likely in older adults or in people with COPD.

If you have diabetes, tell your doctor right away if you have any new sores or other skin problems.

Common Lyrica side effects may include:

• dizziness, drowsiness;
• swelling in your hands and feet;
• trouble concentrating;
• increased appetite;
• weight gain;
• dry mouth; or
• blurred vision.

What is Lyrica?

Lyrica was originally FDA approved as an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. Pregabalin also affects chemicals in the brain that send pain signals across the nervous system.

Lyrica is used to treat pain caused by fibromyalgia, or nerve pain in people with diabetes (diabetic neuropathy), herpes zoster (post-herpetic neuralgia), or spinal cord injury.

Lyrica may also be used for purposes not listed in this medication guide.

Warnings

Lyrica can cause a severe allergic reaction. Stop taking this medicine and seek emergency medical help if you have hives or blisters on your skin, trouble breathing, or swelling in your face, mouth, or throat.

Some people have thoughts about suicide while taking Lyrica. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

If you have diabetes or heart problems, call your doctor if you have weight gain or swelling in your hands or feet while taking Lyrica.

Do not stop using this medicine suddenly, even if you feel fine. Stopping suddenly may cause withdrawal symptoms.

Do not change your dose without your doctor’s advice. Tell your doctor if the medication does not seem to work as well in treating your condition.

Before taking this medicine

You should not use Lyrica if you are allergic to pregabalin.

To make sure Lyrica is safe for you, tell your doctor if you have ever had:

• lung disease, such as chronic obstructive pulmonary disease (COPD);
• a mood disorder, depression, or suicidal thoughts;
• heart problems (especially congestive heart failure);
• a bleeding disorder, or low levels of platelets in your blood;
• kidney disease (or if you are on dialysis);
• diabetes (unless you are taking pregabalin to treat diabetic neuropathy);
• drug or alcohol addiction; or
• a severe allergic reaction (angioedema).

Do not give this medicine to a child without medical advice.

• Pregabalin is not approved for use by anyone younger than 18 years old to treat nerve pain caused by fibromyalgia, diabetes, herpes zoster, or spinal cord injury.
• Pregabalin is not approved for seizures in anyone younger than 1 month old.

Some people have thoughts about suicide while taking Lyrica. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Follow your doctor’s instructions about taking seizure medication if you are pregnant. Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking this medicine without your doctor’s advice, and tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of pregabalin on the baby.

Pregabalin can temporarily decrease sperm count and may affect fertility in men (your ability to have children). In animal studies, pregabalin also caused birth defects in the offspring of males treated with this medicine. However, it is not known whether these effects would occur in humans. Ask your doctor about your risk.

You should not breastfeed while using pregabalin.

How should I take Lyrica?

Take Lyrica exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take the medicine at the same time each day, with or without food.

Do not crush, chew, or break an extended-release tablet. Swallow the tablet whole.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Call your doctor if your symptoms do not improve, or if they get worse.

Do not stop using Lyrica suddenly, even if you feel fine. Stopping suddenly may cause increased seizures or unpleasant withdrawal symptoms. Follow your doctor’s instructions about tapering your dose for at least 1 week before stopping completely.

In case of emergency, wear or carry medical identification to let others know you take seizure medication.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What to avoid

Avoid drinking alcohol. It may increase certain side effects of Lyrica.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Lyrica side effects

Lyrica can cause a severe allergic reaction. Stop taking this medicine and get emergency medical help if you have: hives or blisters on your skin; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• weak or shallow breathing;
• blue-colored skin, lips, fingers, and toes;
• confusion, extreme drowsiness or weakness;
• vision problems;
• skin sores (if you have diabetes);
• easy bruising, unusual bleeding;
• swelling in your hands or feet, rapid weight gain (especially if you have diabetes or heart problems); or
• unexplained muscle pain, tenderness, or weakness (especially if you also have fever or don’t feel well).

Pregabalin can cause life-threatening breathing problems. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Breathing problems may be more likely in older adults or in people with COPD.

If you have diabetes, tell your doctor right away if you have any new sores or other skin problems.

Common Lyrica side effects may include:

• dizziness, drowsiness;
• swelling in your hands and feet;
• trouble concentrating;
• increased appetite;
• weight gain;
• dry mouth; or
• blurred vision.

What is Neurontin?

Neurontin is an anti-epileptic drug, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.

Neurontin is used in adults to treat neuropathic pain (nerve pain) caused by herpes virus or shingles (herpes zoster).

Neurontin is also used to treat seizures in adults and children who are at least 3 years old.

Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form.

Warnings

Do not stop using Neurontin suddenly, even if you feel fine.

Gabapentin can cause life-threatening breathing problems, especially if you already have a breathing disorder or if you use other medicines that can make you drowsy or slow your breathing. Seek emergency medical attention if you have very slow breathing.

Some people have thoughts about suicide or behavior changes while taking Neurontin. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Before taking this medicine

You should not use Neurontin if you are allergic to gabapentin.

To make sure Neurontin is safe for you, tell your doctor if you have ever had:

• breathing problems or lung disease, such as chronic obstructive pulmonary disease (COPD);
• kidney disease (or if you are on dialysis);
• diabetes;
• depression, a mood disorder, or suicidal thoughts or actions;
• a drug addiction;
• a seizure (unless you take Neurontin to treat seizures);
• liver disease;
• heart disease; or
• (for patients with RLS) if you are a day sleeper or work a night shift.

Some people have thoughts about suicide while taking this medicine. Children taking Neurontin may have behavior changes. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking Neurontin for seizures without your doctor’s advice, and tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of gabapentin on the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How should I take Neurontin?

Take Neurontin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy.

Neurontin can be taken with or without food.

If you break a tablet and take only half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.

Swallow the capsule or tablet whole and do not crush, chew, break, or open it.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Do not stop using Neurontin suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

In case of emergency, wear or carry medical identification to let others know you have seizures.

This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Neurontin.

Store Neurontin tablets and capsules at room temperature away from light and moisture.

Store the liquid medicine in the refrigerator. Do not freeze.

Dosing information

Usual Adult Dose for Epilepsy:

Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
Maintenance dose: 300 to 600 mg orally 3 times a day
Maximum dose: 3600 mg orally daily (in 3 divided doses)
-Maximum time between doses in the 3 times a day schedule should not exceed 12 hours

Comment:
-May be taken with or without food.
-Half-tablets not used within 28 days of breaking the scored tablet should be discarded.

Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization

Usual Adult Dose for Postherpetic Neuralgia:

-Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
-Titrate up as needed for pain relief
-Maximum dose: 1800 mg per day (600 mg orally 3 times a day)
COMMENT:
-May be taken with or without food.
-Half-tablets not used within 28 days of breaking the scored tablet should be discarded.

Usual Pediatric Dose for Epilepsy:

Less than 3 years: Not recommended

Greater than or equal to 3 and less than 12 years:
Starting Dose: Ranges from 10 to 15 mg/kg/day in 3 divided doses
Effective Dose: Reached by upward titration over a period of approximately 3 days; the effective dose in patients 5 years of age and older is 25 to 35 mg/kg/day in divided doses (3 times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (3 times a day). Gabapentin may be administered as capsule, or tablet, or using combinations of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long term clinical study. The maximum time interval between doses should not exceed 12 hours.

Greater than 12 years:
-Initial dose: 300 mg orally on day one, 300 mg orally 2 times a day on day two, then 300 mg orally 3 times a day on day three
-Maintenance dose: 900 to 1800 mg orally in 3 divided doses; the dose may be increased up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.

Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization in patients 3 years of age and older

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What to avoid

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Avoid taking an antacid within 2 hours before you take Neurontin. Antacids can make it harder for your body to absorb gabapentin.

Avoid drinking alcohol while taking Neurontin.

Neurontin side effects

Get emergency medical help if you have signs of an allergic reaction to Neurontin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, upper stomach pain, or yellowing of your skin or eyes.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• weak or shallow breathing;
• blue-colored skin, lips, fingers, and toes;
• confusion, extreme drowsiness or weakness;
• problems with balance or muscle movement;
• unusual or involuntary eye movements; or
• increased seizures.

Gabapentin can cause life-threatening breathing problems. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Breathing problems may be more likely in older adults or in people with COPD.

Some side effects are more likely in children taking Neurontin. Contact your doctor if the child taking this medicine has any of the following side effects:

• changes in behavior;
• memory problems;
• trouble concentrating; or
• acting restless, hostile, or aggressive.

Common Neurontin side effects may include:

• fever, chills, sore throat, body aches, unusual tiredness;
• jerky movements;
• headache;
• double vision;
• swelling of your legs and feet;
• tremors;
• trouble speaking;
• dizziness, drowsiness, tiredness;
• problems with balance or eye movements; or
• nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA .

What other drugs will affect Neurontin?

Using Neurontin with other drugs that make you drowsy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, cold or allergy medicine, a muscle relaxer, or medicine for anxiety or seizures.

other drugs may interact with gabapentin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is pregabalin?

Pregabalin was originally FDA approved in 2004 as an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. Pregabalin also affects chemicals in the brain that send pain signals across the nervous system.

Pregabalin is used to treat pain caused by fibromyalgia, or nerve pain in people with diabetes (diabetic neuropathy), herpes zoster (post-herpetic neuralgia), or spinal cord injury.

Pregabalin is also used with other medications to treat partial-onset seizures in adults and children aged at least 1 month.

Warnings

Pregabalin can cause a severe allergic reaction. Stop taking pregabalin and seek emergency medical help if you have hives or blisters on your skin, trouble breathing, or swelling in your face, mouth, or throat.

Some people have thoughts about suicide while taking pregabalin. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

If you have diabetes or heart problems, call your doctor if you have weight gain or swelling in your hands or feet while taking pregabalin.

Do not stop using pregabalin suddenly, even if you feel fine. Stopping suddenly may cause withdrawal symptoms.

Before taking this medicine

You should not use pregabalin if you are allergic to it.

Tell your doctor if you have ever had:

• lung disease, such as chronic obstructive pulmonary disease (COPD);
• a mood disorder, depression, or suicidal thoughts;
• heart problems (especially congestive heart failure);
• a bleeding disorder, or low levels of platelets in your blood;
• kidney disease (or if you are on dialysis);
• diabetes (unless you are taking pregabalin to treat diabetic neuropathy);
• drug or alcohol addiction; or
• a severe allergic reaction (angioedema).

Do not give this medicine to a child without medical advice.

• Pregabalin is not approved for use by anyone younger than 18 years old to treat nerve pain caused by fibromyalgia, diabetes, herpes zoster, or spinal cord injury.
• Pregabalin is not approved for seizures in anyone younger than 1 month old.

Some people have thoughts about suicide while taking pregabalin. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking pregabalin without your doctor’s advice, and tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of pregabalin on the baby.

Pregabalin can decrease sperm count and may affect fertility in men (your ability to have children). In animal studies, pregabalin also caused birth defects in the offspring of males treated with this medicine. However, it is not known whether these effects would occur in humans. Ask your doctor about your risk.

You should not breastfeed while using pregabalin.

How should I take pregabalin?

Take pregabalin exactly as prescribed by your doctor and read all medication guides or instruction sheets about pregabalin. Your doctor may occasionally change your dose.

Take pregabalin at the same time each day, with or without food.

Swallow extended-release pregabalin tablets whole and do not crush, chew, or break them.

Measure pregabalin liquid medicine carefully. Use the dosing syringe provided or a medicine dose-measuring device (not a kitchen spoon).

Call your doctor if your symptoms do not improve, or if they get worse.

Do not stop using pregabalin suddenly, even if you feel fine. Stopping suddenly may cause increased seizures or unpleasant withdrawal symptoms. Follow your doctor’s instructions about tapering your dose for at least 1 week before stopping completely.

In case of emergency, wear or carry medical identification to let others know you take seizure medication.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

If you miss a dose of pregabalin, then take that dose as soon as you remember. If it is almost time for your next dose, then skip the missed dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while taking pregabalin?

Avoid drinking alcohol. It may increase certain side effects of pregabalin.

Avoid driving or hazardous activity until you know how pregabalin will affect you. Your reactions could be impaired.

Pregabalin side effects

Pregabalin can cause a severe allergic reaction. Stop taking this medicine and get emergency medical help if you have: hives or blisters on your skin; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Pregabalin may cause serious side effects. Call your doctor at once if you have:

• weak or shallow breathing;
• blue-colored skin, lips, fingers, and toes;
• confusion, extreme drowsiness or weakness;
• vision problems;
• skin sores (if you have diabetes);
• easy bruising, unusual bleeding;
• swelling in your hands or feet, rapid weight gain (especially if you have diabetes or heart problems); or
• unexplained muscle pain, tenderness, or weakness (especially if you also have fever or don’t feel well).

Pregabalin can cause life-threatening breathing problems. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Breathing problems may be more likely in older adults or in people with COPD.

If you have diabetes, tell your doctor right away if you have any new sores or other skin problems.

Common side effects of pregabalin may include:

• dizziness, drowsiness;
• swelling in your hands and feet;
• trouble concentrating;
• increased appetite;
• weight gain;
• dry mouth; or
• blurred vision.

What is Sabril?

Sabril is an anticonvulsant used for refractory complex partial seizures in specific patients 2 years and older and to treat infantile spasms 1 month to 2 years old. It can cause serious side effects, including vision loss, and should only be used if the potential benefits outweigh the potential risks.

Sabril (vigabatrin) is thought to work by stabilizing the electrical activity in your brain and calming it. It does this by increasing the amount of an inhibitory neurotransmitter (chemical messenger) called GABA (gamma aminobutyric acid).

What is Sabril used for?

Sabril is FDA-approved to treat refractory complex partial seizures in patients 2 years and older who have not responded to other medicines. It is used together with another anticonvulsant, and only if the potential benefits outweigh the risk of any loss of vision. It is not used as a first-line treatment for complex partial seizures.

Sabril is also FDA-approved to treat infantile spasms in babies and children between the ages of 1 month and 2 years. It should be used if the potential benefits outweigh the potential risk of vision loss. It can be used as a single therapy for infantile spasms.

Warnings

Taking Sabril can cause permanent vision loss, even after you stop using this medicine. Tell your doctor if you have any vision problems, such as retinitis or glaucoma and advise your doctor right away about any changes in your vision. You must have frequent eye exams before, during, and shortly after taking this medicine.

To be sure Sabril is not causing harmful effects on your vision, you will need a thorough eye exam before you start taking the medication and then every 3 months during treatment, even if your vision seems normal. If you ever stop taking this medicine, you may still need to have eye exams every 3 to 6 months after your treatment ends. Do not miss any follow-up visits to your doctor.

Some babies treated with vigabatrin have had abnormal brain changes seen on magnetic resonance imaging (MRI). Tell any doctor who treats your baby that the child is taking this medicine.

Some people have thoughts about suicide while taking seizure medication. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

Some people taking Sabril have developed vision problems within weeks to years after starting treatment. Vision loss caused by vigabatrin may be permanent, and you may notice only mild symptoms at first.Talk to your doctor about this possibility.

Sabril is available only from a certified pharmacy under a special program. You must be registered in the program and agree to have vision exams before, during, and shortly after taking vigabatrin. Be sure you understand the risks and benefits of taking this medicine.

You should not use Sabril if you are allergic to vigabatrin.

To make sure Sabril is safe for you, tell your doctor if you (or the child taking this medicine) have ever had:

• vision problems;
• kidney disease;
• anemia (low red blood cells); or
• depression, a mood disorder, mental illness, or suicidal thoughts or actions.

Some people have thoughts about suicide while taking Sabril. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor’s advice.Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of vigabatrin on the baby.

You should not breastfeed while you are using Sabril.

Do not give this medicine to a child without medical advice.

Sabril pregnancy and breastfeeding warnings

How should I take Sabril?

Take Sabril exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

You may take Sabril with or without food.

Sabril powder must be mixed only with water, and can be given to the child with a meal. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Anyone taking Sabril can develop vision problems that could get worse, even after you stop using this medicine. The more you take this medicine, the more likely you are to develop severe vision problems.

You will need a thorough eye exam before you start taking this medicine and then every 3 months during treatment, even if your vision seems normal. Eye exams may not fully prevent vision damage, but they will help your doctor decide whether to change your treatment plan. Stay alert to any changes in your vision and report them to your doctor right away.

If you stop taking Sabril, you should have another eye exam about 3 to 6 months after your last dose.

It may be more difficult to test vision in a baby or young child. However, your doctor may still prescribe vigabatrin for the child if the benefit of preventing seizures outweighs any risk. Tell the doctor right away if you think your child’s vision may be changing.

Call your doctor if your complex partial seizures do not improve after 3 months of treatment, or if your baby’s infantile spasms do not improve after 2 to 4 weeks of treatment.

Do not stop using Sabril suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

Store in the original container at room temperature away from moisture and heat.

Dosing information

Usual Sabril Adult Dose for Refractory Complex Partial Seizures (17 years of age and older)

Initial dose: 1 g orally daily (administered as one 500 mg orally 2 times daily) with or without food. The total daily dose may be increased in 500 mg increments at weekly intervals depending on response.

Recommended dose: 3 g orally daily (1.5 g orally 2 times daily)

A 6 g daily dose has not been shown to confer additional benefit compared to the 3 g daily dose and is associated with an increased incidence of adverse events.

Approved indication: For adults and children 2 years of age and older as adjunctive therapy for refractory complex partial seizures (CPS) who have inadequately responded to several alternative treatments and for whom the potential benefits outweigh the risk of vision loss. Sabril is not indicated as a first line agent for complex partial seizures.

Usual Sabril Pediatric Dose for Refractory Complex Partial Seizures (2 to 16 years of age)

The recommended dosage is based on body weight and administered as two divided doses. The dosage may be increased in weekly intervals, depending on response. Dose patients weighing more than 60 kg according to adult recommendations.

Usual Pediatric Dose for Infantile Spasms (1 month to 2 years of age)

Initial dose: 50 mg/kg (25 mg/kg twice daily); increase total daily dose every 3 days, in increments of 25 mg/kg/day to 50 mg/kg/day, up to a maximum daily dose of 150 mg/kg (75 mg/kg twice daily).
Each individual dose should be prepared immediately before use and administered cold or at room temperature.

Approved indication: As monotherapy for pediatric patients who are 1 month to 2 years of age with infantile spasms (IS) and for whom the potential benefits outweigh the potential risk of vision loss.

Comments

• Renal Impairment: Dose adjustment is recommended.
• Sabril is available as tablets (500 mg), for oral solution 500 mg per packet
• What happens if I miss a dose?

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Call your doctor for instructions if your baby is taking Sabril and misses a dose, takes only part of a dose, or spits up or vomits after taking the medicine.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe drowsiness or dizziness, confusion, trouble speaking, feeling agitated or irritable, unusual thoughts or behavior, increased seizures, slow heart rate, weak or shallow breathing, or fainting.

What to avoid

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Sabril side effects

Get emergency medical help if you have signs of an allergic reaction to Sabril (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Taking vigabatrin can cause permanent vision loss. Tell your doctor right away about any changes in your vision. If a child is taking Sabril: Tell the doctor right away if the child shows signs of vision changes, such as bumping into things or being easily startled or surprised.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• increased or worsening seizures;
• any change in your vision, no matter how mild;
• unusual or involuntary eye movements;
• severe drowsiness, fussiness, or feeding problems (in a baby taking vigabatrin);
• numbness, tingling, or burning pain in your hands or feet;
• weight gain with or without swelling;
• signs of an ear infection – fever, ear pain or full feeling, trouble hearing, drainage from the ear, fussiness in a child; or
• low red blood cells (anemia) – pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Some babies treated with Sabril have had abnormal brain changes seen on magnetic resonance imaging (MRI). It is not known if these changes are caused by vigabatrin or if they are harmful. Tell any doctor who treats your baby that the child is taking this medicine.

Common Sabril side effects may include:

• blurred vision or other eye problems;
• drowsiness, dizziness, feeling tired;
• problems with walking or coordination;
• tremors or shaking;
• aggressive behavior;
• confusion, problems with thinking or memory;
• weight gain;
• joint pain;
• cold symptoms such as stuffy nose, sneezing, sore throat; or
• (in babies) fussiness, ear infection, cough, breathing problems.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Sabril?

Other drugs may interact with vigabatrin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is Sabril?

Sabril is an anticonvulsant used for refractory complex partial seizures in specific patients 2 years and older and to treat infantile spasms 1 month to 2 years old. It can cause serious side effects, including vision loss, and should only be used if the potential benefits outweigh the potential risks.

Sabril (vigabatrin) is thought to work by stabilizing the electrical activity in your brain and calming it. It does this by increasing the amount of an inhibitory neurotransmitter (chemical messenger) called GABA (gamma aminobutyric acid).

What is Sabril used for?

Sabril is FDA-approved to treat refractory complex partial seizures in patients 2 years and older who have not responded to other medicines. It is used together with another anticonvulsant, and only if the potential benefits outweigh the risk of any loss of vision. It is not used as a first-line treatment for complex partial seizures.

Sabril is also FDA-approved to treat infantile spasms in babies and children between the ages of 1 month and 2 years. It should be used if the potential benefits outweigh the potential risk of vision loss. It can be used as a single therapy for infantile spasms.

Warnings

Taking Sabril can cause permanent vision loss, even after you stop using this medicine. Tell your doctor if you have any vision problems, such as retinitis or glaucoma and advise your doctor right away about any changes in your vision. You must have frequent eye exams before, during, and shortly after taking this medicine.

To be sure Sabril is not causing harmful effects on your vision, you will need a thorough eye exam before you start taking the medication and then every 3 months during treatment, even if your vision seems normal. If you ever stop taking this medicine, you may still need to have eye exams every 3 to 6 months after your treatment ends. Do not miss any follow-up visits to your doctor.

Some babies treated with vigabatrin have had abnormal brain changes seen on magnetic resonance imaging (MRI). Tell any doctor who treats your baby that the child is taking this medicine.

Some people have thoughts about suicide while taking seizure medication. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

Some people taking Sabril have developed vision problems within weeks to years after starting treatment. Vision loss caused by vigabatrin may be permanent, and you may notice only mild symptoms at first. Talk to your doctor about this possibility.

Sabril is available only from a certified pharmacy under a special program. You must be registered in the program and agree to have vision exams before, during, and shortly after taking vigabatrin. Be sure you understand the risks and benefits of taking this medicine.

You should not use Sabril if you are allergic to vigabatrin.

To make sure Sabril is safe for you, tell your doctor if you (or the child taking this medicine) have ever had:

• vision problems;
• kidney disease;
• anemia (low red blood cells); or
• depression, a mood disorder, mental illness, or suicidal thoughts or actions.

Some people have thoughts about suicide while taking Sabril. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking seizure medication during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of vigabatrin on the baby.

You should not breastfeed while you are using Sabril.

Do not give this medicine to a child without medical advice.

How should I take Sabril?

Take Sabril exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

You may take Sabril with or without food.

Sabril powder must be mixed only with water, and can be given to the child with a meal. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Anyone taking Sabril can develop vision problems that could get worse, even after you stop using this medicine. The more you take this medicine, the more likely you are to develop severe vision problems.

You will need a thorough eye exam before you start taking this medicine and then every 3 months during treatment, even if your vision seems normal. Eye exams may not fully prevent vision damage, but they will help your doctor decide whether to change your treatment plan. Stay alert to any changes in your vision and report them to your doctor right away.

If you stop taking Sabril, you should have another eye exam about 3 to 6 months after your last dose.

It may be more difficult to test vision in a baby or young child. However, your doctor may still prescribe vigabatrin for the child if the benefit of preventing seizures outweighs any risk. Tell the doctor right away if you think your child’s vision may be changing.

Call your doctor if your complex partial seizures do not improve after 3 months of treatment, or if your baby’s infantile spasms do not improve after 2 to 4 weeks of treatment.

Do not stop using Sabril suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

Store in the original container at room temperature away from moisture and heat.

Dosing information

Usual Sabril Adult Dose for Refractory Complex Partial Seizures (17 years of age and older)

Initial dose: 1 g orally daily (administered as one 500 mg orally 2 times daily) with or without food. The total daily dose may be increased in 500 mg increments at weekly intervals depending on response.

Recommended dose: 3 g orally daily (1.5 g orally 2 times daily)

A 6 g daily dose has not been shown to confer additional benefit compared to the 3 g daily dose and is associated with an increased incidence of adverse events.

Approved indication: For adults and children 2 years of age and older as adjunctive therapy for refractory complex partial seizures (CPS) who have inadequately responded to several alternative treatments and for whom the potential benefits outweigh the risk of vision loss. Sabril is not indicated as a first line agent for complex partial seizures.

Usual Sabril Pediatric Dose for Refractory Complex Partial Seizures (2 to 16 years of age)

The recommended dosage is based on body weight and administered as two divided doses. The dosage may be increased in weekly intervals, depending on response. Dose patients weighing more than 60 kg according to adult recommendations.

Usual Pediatric Dose for Infantile Spasms (1 month to 2 years of age)

Initial dose: 50 mg/kg (25 mg/kg twice daily); increase total daily dose every 3 days, in increments of 25 mg/kg/day to 50 mg/kg/day, up to a maximum daily dose of 150 mg/kg (75 mg/kg twice daily).
Each individual dose should be prepared immediately before use and administered cold or at room temperature.

Approved indication: As monotherapy for pediatric patients who are 1 month to 2 years of age with infantile spasms (IS) and for whom the potential benefits outweigh the potential risk of vision loss.

Comments

• Renal Impairment: Dose adjustment is recommended.
• Sabril is available as tablets (500 mg), for oral solution 500 mg per packet
• What happens if I miss a dose?

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Call your doctor for instructions if your baby is taking Sabril and misses a dose, takes only part of a dose, or spits up or vomits after taking the medicine.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include severe drowsiness or dizziness, confusion, trouble speaking, feeling agitated or irritable, unusual thoughts or behavior, increased seizures, slow heart rate, weak or shallow breathing, or fainting.

What to avoid

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Sabril side effects

Get emergency medical help if you have signs of an allergic reaction to Sabril (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Taking vigabatrin can cause permanent vision loss. Tell your doctor right away about any changes in your vision. If a child is taking Sabril: Tell the doctor right away if the child shows signs of vision changes, such as bumping into things or being easily startled or surprised.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• increased or worsening seizures;
• any change in your vision, no matter how mild;
• unusual or involuntary eye movements;
• severe drowsiness, fussiness, or feeding problems (in a baby taking vigabatrin);
• numbness, tingling, or burning pain in your hands or feet;
• weight gain with or without swelling;
• signs of an ear infection – fever, ear pain or full feeling, trouble hearing, drainage from the ear, fussiness in a child; or
• low red blood cells (anemia) – pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Some babies treated with Sabril have had abnormal brain changes seen on magnetic resonance imaging (MRI). It is not known if these changes are caused by vigabatrin or if they are harmful. Tell any doctor who treats your baby that the child is taking this medicine.

Common Sabril side effects may include:

• blurred vision or other eye problems;
• drowsiness, dizziness, feeling tired;
• problems with walking or coordination;
• tremors or shaking;
• aggressive behavior;
• confusion, problems with thinking or memory;
• weight gain;
• joint pain;
• cold symptoms such as stuffy nose, sneezing, sore throat; or
• (in babies) fussiness, ear infection, cough, breathing problems.

What is gabapentin?

Gabapentin (Neurontin, Gralise, Horizant) is a medicine used to treat partial seizures, nerve pain from shingles and restless leg syndrome. It works on the chemical messengers in your brain and nerves.  Gabapentin is from a group of medicines called anticonvulsants. 

Different brands of gabapentin are not interchangeable and they are FDA approved for different conditions. Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form. 

Neurontin (gabapentin) is used to treat pain you may have from shingles (postherpetic nerve pain). It is also used with other seizure medicines for partial onset seizures in patients 3 years and older.

Gralise (gabapentin) is only used for pain after having shingles (postherpetic nerve pain). It should not be used for any other medical condition.

Horizant (gabapentin enacarbil) is an extended release tablet used to treat restless legs syndrome and for the pain from having shingles (postherpetic nerve pain).

Generic brands of gabapentin capsules, USP are used for postherpetic nerve pain and for add on therapy for partial onset seizures in patients 3 years and older

Warnings

Gabapentin can cause life-threatening breathing problems, especially if you already have a breathing disorder or if you use other medicines that can make you drowsy or slow your breathing. Seek emergency medical attention if you have very slow breathing.

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.

Seizures may increase if you stop using gabapentin suddenly. Ask your doctor before stopping the medicine.

Avoid driving or hazardous activity until you know how gabapentin will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Do not stop using gabapentin suddenly, even if you feel fine.

Before taking this medicine

You should not take gabapentin if you are allergic to it.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• breathing problems;
• diabetes;
• depression, a mood disorder, or suicidal thoughts or actions;
• drink alcohol;
• a history of drug addiction;
• a seizure;
• (patients with RLS) if you are a day sleeper or work a night shift; or
• kidney disease (or if you are on dialysis).

Some people have thoughts about suicide while taking seizure medicine. Children taking gabapentin may have behavior changes. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

It is not known if gabapentin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Do not start or stop seizure medication during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of gabapentin on the baby.

Ask a doctor if it is safe to breastfeed while using gabapentin.

Gabapentin pregnancy and breastfeeding warnings 

How should I take gabapentin?

Take gabapentin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Never take gabapentin in larger amounts, or for longer than prescribed.

Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the medicine your doctor prescribes.

Both Gralise and Horizant should be taken with food.

Neurontin can be taken with or without food.

If you break a tablet and take only half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.

Swallow the tablets of Gralise and Horizant whole. Do not crush, break, or dissolve them. Swallow the capsule whole and do not crush, chew, break, or open the capsule.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Doses are based on weight in children. Your child’s dose may change if the child gains or loses weight.

You should not stop taking gabapentin suddenly. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using gabapentin.

Your kidney function may need to be checked often and your dose may change based on the results.

Store tablets and capsules at room temperature away from moisture and heat.

Store the liquid medicine in the refrigerator, do not freeze.

Follow all storage instructions provided. Your pharmacist can provide more information about how to store this medicine.

Dosing information

Usual Adult Dose for Epilepsy:

Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
Maintenance dose: 300 to 600 mg orally 3 times a day
Maximum dose: 3600 mg orally daily (in 3 divided doses)
-Maximum time between doses in the 3 times a day schedule should not exceed 12 hours

-The safety and effectiveness of gabapentin available under the trade name Gralise or Horizant in patients with epilepsy has not been studied.

Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization

Usual Adult Dose for Postherpetic Neuralgia:

-Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
-Titrate up as needed for pain relief
-Maximum dose: 1800 mg per day (600 mg orally 3 times a day)
Gabapentin available under the trade name Gralise:
-Maintenance dose: Gralise should be titrated to 1800 mg orally once daily with the evening meal.
-Recommended titration schedule:
Day 1: 300 mg orally with the evening meal
Day 2: 600 mg orally with the evening meal
Days 3 through 6: 900 mg orally with the evening meal
Days 7 through 10: 1200 mg orally with the evening meal
Days 11 through 14: 1500 mg orally with the evening meal
Day 15: 1800 mg orally with the evening meal
COMMENT:
-Gralise is not interchangeable with other gabapentin products because of differing pharmacokinetic profiles that affect the frequency of administration.

Gabapentin enacarbil extended release tablets are available under the trade name Horizant:
-The recommended dosage is 600 mg orally 2 times a day. Therapy should be initiated at a dose of 600 mg orally in the morning for 3 days of therapy, then increased to 600 mg 2 times a day (1200 mg/day) on day four.
COMMENT:
Gabapentin enacarbil extended release tablets available under the trade name Horizant and gabapentin are not interchangeable.

Use: Postherpetic neuralgia

Usual Adult Dose for Restless Legs Syndrome:

Gabapentin enacarbil available under the trade name Horizant:
600 mg orally once daily with food at about 5 PM

Use: For the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS) in adults

Usual Pediatric Dose for Epilepsy:

Less than 3 years: Not recommended

Greater than or equal to 3 and less than 12 years:
Starting Dose: Ranges from 10 to 15 mg/kg/day in 3 divided doses
Effective Dose: Reached by upward titration over a period of approximately 3 days; the effective dose in patients 5 years of age and older is 25 to 35 mg/kg/day in divided doses (3 times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (3 times a day). Gabapentin may be administered as the oral solution, capsule, or tablet, or using combinations of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long term clinical study. The maximum time interval between doses should not exceed 12 hours.

Greater than 12 years:
-Initial dose: 300 mg orally on day one, 300 mg orally 2 times a day on day two, then 300 mg orally 3 times a day on day three
-Maintenance dose: 900 to 1800 mg orally in 3 divided doses; the dose may be increased up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.

Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization in patients 3 years of age and older<

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

If you take Horizant: skip the missed dose and take your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal.

Overdose symptoms may include slow breathing, double vision, tremor, slurred speech, drowsiness, change in your mental state, dizziness, tiredness, or diarrhea.

What should I avoid while taking gabapentin?

Avoid driving or hazardous activity until you know how gabapentin will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Avoid taking an antacid within 2 hours before you take gabapentin.

Do not drink alcohol. Dangerous side effects could occur.

Gabapentin side effects

Get emergency medical help if you have signs of an allergic reaction to gabapentin: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body.Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Gabapentin can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Some side effects are more likely in children taking gabapentin. Call your doctor if the child has any of the following side effects: behavior changes, memory problems, trouble concentrating, or acting restless, hostile, or aggressive.

Gabapentin may cause serious side effects. Call your doctor at once if you have:

• drowsiness, dizziness, weakness;
• problems with balance or muscle movement; or
• increased seizures.

Common gabapentin side effects may include:

• fever, chills, sore throat, body aches, tiredness;
• headache;
• swelling of your legs and feet;
• trouble speaking;
• vision problems, dizziness, drowsiness;
• tremors, problems with balance or muscle movement; or
• nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Gabapentin side effects 

What other drugs will affect gabapentin?

Taking gabapentin with other drugs that make you drowsy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your current medicines. Many drugs can affect gabapentin, especially:

• naproxen;
• opioid medicine – hydrocodone, oxycodone, morphine, buprenorphine;
• zolpidem;
• lorazepam; or
• cimetidine.

This list is not complete and many other drugs may affect gabapentin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.